Plaque And Tartar Control

Patients often confuse plaque and tartar and how they relate to each other. Plaque is a sticky, colorless deposit of bacteria that is constantly forming on teeth. Saliva, food and fluids combine to produce these deposits that collect on teeth and where teeth and gums meet.

Plaque buildup is the primary factor in gum (periodontal) disease.  Fighting plaque is a life-long component of oral care. Plaque begins forming on teeth 4 to 12 hours after brushing, which is why it is so important to brush at least twice a day and floss daily.

Plaque which is not removed by regular brushing and flossing can harden into tartar (also called calculus).  This crusty deposit creates a cohesive bond that can only be removed by a dentist or hygienist. Tartar formation may also make it more difficult for you to remove new plaque and bacteria. 

You can help reduce the formation of calculus by brushing with the correct technique so that the toothbrush bristles go beneath the gums and by flossing on a daily basis. Having the appropriate interval between professional cleanings is also important. Not everyone forms calculus at the same rate, so some people need more professional help than others.

If there is any sign of gum disease, the research has shown that the ideal interval between professional cleanings is 3 months. Plaque is a collection of different bacteria and as it matures it colonizes and reaches the stage of being destructive to gums and dental bone at 3 months. When you have a professional cleaning at 3 month intervals you are disrupting the bacterial colonies and are basically making them start all over again, thereby stopping or at least slowing down the harm plaque bacteria can cause.

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Understanding Tooth Decay

Tooth decay occurs when the enamel of the teeth is attacked by acid produced by decay-causing bacteria.  Every time you eat something with sugar in it, the bacteria are fed and they produce acid when they eat. The acid attack on your teeth lasts for 20 minutes after introducing the sugar into your mouth. That’s why it’s important to be aware of snacking and what’s in your snacks and in between meal drinks. Every time you eat or drink something with sugar in it, whether it’s a lot or a little bit of sugar, there will be an acid attack for 20 minutes after eating or drinking the sugar.

Think about your eating and drinking habits. Are you making your teeth suffer acid attacks for hours each day? It helps to swish and swallow some water after eating if you can’t brush your teeth.

Tooth enamel is the outside of the tooth and it is hard and porous. It consists of many closely-packed rods made of minerals. The acid I mentioned that forms after eating seeps into the enamel’s pores. This causes mineral to be lost from the enamel (a process called demineralization). When mineral is lost from the enamel, the enamel softens and this demineralized spot is a weak spot in the tooth’s surface. If the enamel doesn’t have a chance to remineralize, that is what the decay is – softened, demineralized enamel with bacteria in it. The decay progresses and forms a cavity in the tooth.

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Tooth Decay and Fluoride

When we detect a weak spot on one of our patient’s teeth we recommend at–home fluoride treatments to reverse the decay process. If the weak spot is left unchecked, a cavity may form, necessitating a filling. If decay is allowed to spread it may penetrate deeper into the tooth until it enters the nerve chamber of the tooth. Once this happens the nerve of the tooth is infected and the bacteria that caused the decay keep traveling through the chamber, to the roots, through the root canals and eventually can cause an abscess at the tip of the root. This can also result in the destruction of dental bone at the tip of the tooth root. Decay going through these stages results in the need for root canal therapy in order to save the tooth and stop the infection. If the root canal therapy isn’t done, the tooth needs to be extracted to prevent the spread of infection.

Tooth decay often begins on biting surfaces, between the teeth, and on exposed roots. Cavities left untreated become larger. The decay spreads beneath the enamel, which is the outer part of the crown of the tooth, and can destroy the tooth structure.

Fluoride helps prevent tooth decay by slowing the breakdown of enamel and speeding up the natural remineralization process. Common sources of fluoride are fluoridated drinking water, toothpaste and mouth rinse. Most NJ water is not fluoridated, so it’s important to understand the best way to protect your teeth and your family’s teeth from decay with the help of fluoride. We discuss which sources of fluoride are best for our patients.

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More About Keeping Your Baby's Teeth Healthy

Baby teeth

Your baby has his first pearly whites - but is it really necessary to visit the dentist this early?

According to the American Academy of Pediatric Dentistry and many other dental authorities across the world, the answer is yes. It’s recommended you take him for a dental check-up at some point during his first year, or certainly by the time all his baby teeth are in his mouth (which is at about 21/2 years).

When you bring your young child in for their first dental visit at an early age it gives us an opportunity to spot potential problems at an early stage and also to decide upon a good prevention program. Plus, it helps get your baby accustomed to the sights and sounds of the dentist's office and can prevent him becoming anxious about dental visits in the future.

There are several cautions we mention to the parents of our youngest patients to help protect them.  We recommend that you do not dip your child’s pacifier into any sweet substance.  Don’t add sugar to your child’s food.  You don’t want your baby to learn a preference for sweet food.

Remember that bedtime is the most important time to clean your baby’s teeth.  There’s less saliva during the night, which means that there’s less rinsing action while your baby’s sleeping.  This results in harmful bacteria in your baby’s mouth settling more easily on the baby teeth.

Also, if you need to give your baby oral medication, you should do it before you brush his teeth, rather than afterwards. Did you know that most oral medications for infants contain sucrose (a type of sugar)?!

Last, but not least important, giving your baby water is always the healthiest option when he needs extra fluids.

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Keeping Your Baby's Teeth Healthy

baby teeth

Brushing is the most important thing for your baby's dental care, but those precious teeth need more than just regular cleanings to stay healthy. Below are a number of ways to keep your child's teeth in top shape for life.

Minerals and vitamins: Your baby needs the right building blocks to construct her pearly whites, and that means an adequate intake of calcium, phosphorus, fluoride, and other minerals and vitamins (particularly Vitamin C, which is a great to keep gums healthy).

Give cheese: Can't brush baby's teeth after she's had a high-carb or sugary snack? Slip her a slice of cheese. In addition to their high calcium content, cheeses, like Swiss and cheddar, encourage saliva production, which helps clear cavity-causing acids and sugars from the mouth.

Sugar: It may seem impossible to completely avoid sugars in your baby's diet, but you'll want to limit them as much as possible — particularly refined sugars (which are found in, of all things, commercial teething biscuits) and sticky natural sugars (such as those in dried fruits). Keep sweets to an asbolute minimum — no more than once or twice a day — and serve only with meals.

Use cups: Your baby may still love her bottle, but you'll want to get her used to drinking from a cup. Bottles and sippy cups containing milk or juice have been associated with tooth decay because they allow the liquid to pool in baby's mouth and on the teeth. If you’re afraid your baby will make too much of a mess drinking from a cup, use a sippy with a straw or just put water or very diluted juice in the sippy.

Reduce the juice: To cut back on sugar, only offer juice in a watered-down form and only with snacks and meals, not as an all-purpose tummy filler.

No nighttime bottles: Although your baby may love the comfort her bottle provides, don't let her go to sleep with one. She may (and probably will) leave the nipple in her mouth, and the drips and drops of fluid that dribble out can be broken down into acid, which erode those newly erupted teeth. Even if your child is still without any baby teeth, ban the bottle for sleeping, because it will only be that much harder to take away later.

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Brushing Your Baby's Teeth

It is as important to care for your baby's first teeth as it is to care for his permanent teeth when he's older. Yes - his baby teeth will fall out, but in the meantime they serve some important functions.

Baby teeth are responsible for "reserving" spaces for the permanent teeth to grow into. When baby teeth are lost, it can cause the permanent teeth to shift - and this can cause orthodontic problems as your child grows. Your baby needs his baby teeth in order to learn to speak correctly and clearly. Your baby's milk teeth are necessary for biting and chewing. If your child loses too many baby teeth, it can affect his confidence once he reaches pre-school. Sadly, children can be very unkind when it comes to pointing out differences in others.

As soon as baby's first tooth erupts, it's time to buy a good toothbrush. The best type to use at first is a long handled brush with a small head. This design makes it easy to reach all areas of your baby's mouth.

Your baby's toothbrush should have rounded, soft filaments. You should replace it every 10-12 weeks, or sooner if the filaments become splayed.

Another option is to use a specially designed infant toothbrush that fits over your finger. Some babies seem to prefer this type... but beware! If your baby is a biter, a toothbrush of this type offers your vulnerable finger very little protection!

As your baby grows and wants to hold the brush himself, then it's a good idea to buy him one with a chunky handle. This will be easier for him to hold - but, of course, you will still need to do the majority of the brushing yourself!

It isn't absolutely essential to use toothpaste to clean your baby's teeth - the brushing action itself is actually the most important part of keeping them clean. If you prefer to use toothpaste, then you should choose one that is designed specifically for infants, because they contain very little - if any - fluoride. In fact, the American Association of Pediatric Dentistry guidelines suggest that babies under the age of 2 receive NO fluoride at all.

Fluoride helps strengthen the enamel of teeth. However, too much of it can cause fluorosis, which is a condition where white spots can appear on the permanent teeth. If you use an adult toothpaste to brush your baby's teeth, which contains the amount of fluoride recommended for adults, you run the risk of him developing fluorosis. This is because babies tend to swallow rather a lot of toothpaste during brushing and are thereby swallowing excess fluoride.

If your baby won't open his mouth when it's time to brush his teeth, then try putting a brush in your mouth. Your baby loves to mimic you. You can also make your baby laugh. 

Sit your baby in the most comfortable position for both of you - try standing or sitting behind  your baby as he looks up. This is an excellent position to adopt, because it makes it very easy to reach all parts of his mouth. Be gentle - it isn't necessary to brush firmly at this stage and it may just put your baby off having his teeth brushed altogether!

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Baby Teeth Care: Teething Tips and Tooth Care

It breaks your heart to see your child uncomfortable with teething pain and you want to know what you can do. The best remedies are cold and pressure. Cold slightly numbs the area, and pressure provides a counter sensation that feels good. Wet a washcloth, stick it in the freezer for 30 to 60 minutes, and let your child chew on it. You can also chill some teething rings. 

Many parents have been told by their mothers or grandmothers to rub whiskey on their baby’s gums to help with teething pain, but it really isn’t advisable. Another popular remedy is homeopathic teething tablets.  However, the active ingredient, an herb called belladonna, in large doses can cause hallucinations, difficulty breathing, increased heart rate and other problems. So be careful. Cold and pressure are the best and safest remedies for baby teething care.

When a tooth is getting ready to erupt it stretches the gum area as tight as a drum. To some children, that tightness is interpreted by their brain as being painful.  For others, it’s just like an itch they have to scratch.  Different children just have a different perception of what is and what isn’t pain. 

Many parents wonder if it is okay to give acetaminophen or ibuprofen to stop pain. Ibuprofen should only be used for babies older than 6 months. After that, either medication is fine when given in the correct dose and administered judiciously. But parents should first ask themselves if their child really needs the drug.  Ibuprofen isn’t necessarily more effective because it’s known to relieve inflammation as well as pain. What’s happening with your child’s mouth is primarily irritation. We recommend being as conservative in your approach to pain management as possible.

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